This is the first multicenter, randomized, placebo-controlled trial of peanut SLIT," write David M. Fleischer, MD, from the Department of Pediatrics, National Jewish Health, Denver, Colorado, and colleagues. "The study achieved its primary efficacy end point, demonstrating that treatment with peanut SLIT induces a statistically significant degree of desensitization in a majority of subjects compared with placebo."

After a baseline oral food challenge (OFC) of up to 2 g of peanut powder, 40 participants between the ages of 12 and 37 years were randomly assigned to receive either placebo or peanut SLIT. After 44 weeks, a 5-g OFC was performed, the study was unblinded, and placebo-treated participants were crossed-over to a higher-dose peanut SLIT. Another 5-g OFC was performed 44 weeks later. The researchers compared OFC results for both groups, with responders defined as those participants who successfully consumed either 5 g or at least 10-fold more peanut powder than the baseline OFC threshold.

Seventy percent (14/20) of the participants receiving peanut SLIT showed a positive response after 44 weeks of immunotherapy compared with 15% (3/20) of those receiving placebo ( P < .001). Responders in the peanut SLIT group had an increase in the median successfully consumed dose (SCD) of peanut powder from 3.5 to 496 mg. The median SCD increased further to 996 mg at week 68 ( P = .05 compared with week 44). Among the participants who crossed over from placebo to peanut SLIT, 44% (7/16) were responders and had an increase in the median SCD from 21 to 496 mg

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